Peculiarities of prolonged neonatal jaundice and possibility of their pharmacological correction

Purpose: to study of peculiarities of prolonged neonatal jaundice and the possibility of pharmacological correction based on ursodeoxycholic acid.

Patients and methods. Were examined 42 children (29 boys and 13 girls) with prolonged neonatal jaundice. The study group included 22 children, who in complex of pharmacological treatment received the ursodeoxycholic acid, the comparison group comprised 20 children who received only basic treatment such as phototherapy. The effectiveness of the treatment was evaluated by biochemical parameters of blood (bilirubin and its fractions, liver transaminase), the level of serum alpha&fetoprotein, epidermal growth factor were determined by ELISA.

Results. All children were full term. The mean age of children in the study group was 20.8±1.9 days in the control group and 22±1.5 days. In the main group indirect bilirubin was above on 35 μmol/l, but significant differences in the level of indirect bilirubin were absent at the beginning of treatment in both groups of children included in the study, respectively, 286±14,3 μmol/l and 250±16.4 μmol/l (p>0.05). The average indirect bilirubin after treatment significantly decreased in both groups but in the main group, a decline of 49% in the comparison group decrease of bilirubin was on 30%. It was also noted signs of neonatal cholestasis: every fifth child had the increased level of direct bilirubin, every third child had elevated liver transaminase. Also, there were no significant differenses in the mean levels of serum AFP and EGF, there were higher in children of both study groups, respectively, mean level of serum AFP in the main group was 834±28 ng/ml in the comparison group — 809±26 ng/ml(p>0.05); mean level of serum EGF in the main group 651±57,2 ng/ml in the comparison group — 714±27 ng/ml(p>0.05). However, in children who were treated with ursodeoxycholic acid (UkrlivR suspension) the levels of serum AFP and EGF were significantly decreased, in average on 50%.

Conclusions. The use in pharmacological treatment of ursodeoxycholic acid in children with prolonged neonatal jaundice and/or signs of neonatal cholestasis reduces the duration of visual jaundice, also leads to a more rapid decrease of serum total bilirubin(1.3 times) and on 50% decrease levels of AFP and EGF and reduce the time spent in the hospital for 3 days.